Time to rise to the dementia challenge

Britain can learn from the Japanese experience of designing and building for dementia care, argues Jitesh Patel, Senior Development Manager, Kajima Partnerships.

Every three seconds someone somewhere in the world is diagnosed with dementia. In the UK there are over 850,000 people living with the disease, a figure which is expected to rise to one million by 2025. As the demographic landscape of the UK shifts, dementia is having a major, and growing impact on health and social care today.

The design and construction industry must rise to this challenge, drawing on international best practice and the latest research, if we’re to accommodate the desperate demand for dementia care, and deliver high quality, patientcentric facilities.

The economic implications of the disease are momentous. Dementia costs the UK £26.4 billion a year in healthcare, social, and other costs. Rather than fearing the additional expenditure associated with developing dementia care facilities, perhaps we should be considering the opportunity.

Currently, a quarter of UK hospital beds are occupied by dementia sufferers, augmenting the strain felt across a sector already in a crisis. Providing specialist stand-alone and integrated dementia facilities will not only ease the desperate bed-blocking currently threatening to choke the NHS, but will lay the oundations for future best practice.

Pressing issue

In Japan, a country where one in four people are over 65, there is already widespread commitment to funding for high-quality services, and a shared understanding that the entire system of accessible care should be properly funded, with costs split between the government and society.

Learning from Japan, the UK must seize the opportunity to address this pressing issue now, by developing modern healthcare buildings that sensitively and intelligently cater for the current and future demand of dementia in the UK.

One of the many innovations coming out of Japan is the integration of dementia care with general elderly care facilities. The Juntendo Tokyo Koto Geriatric Medical Centre is a hospital dedicated to the medical treatment for dementia and other geriatric diseases that, combined with neighbouring facilities, forms part of a multiple complex for elderly people requiring long-term care, rehabilitation and health promotion.

Understanding

Any new facility must have the ability to service its catchment population. A comprehensive understanding of the current and future dementia requirements of the local population is therefore vital if a facility is to be fit for purpose.

Where possible, the building design should be developed in tandem with its service model, and careful consideration given to the location of the proposed site.

Given the progressive nature of dementia, it is important that patients in the earlier stages of the disease are able to maintain a level of independence making good access to community facilities and good public transport imperative, so that patients can undertake trips independently.

It’s important to make sure the interior of these facilities be ‘dementia-transparent’ – an environment that offers full care functionality but with the look and feel of a sophisticated household.

Ensuring there is clear signage, natural light, secure handrails and coloured, textured ‘tactile indicators’ that support the complex array of associated symptoms, including increased frailty, memory loss, mood changes, and problems with communication and reasoning.

Aside from the fixtures and fittings, care must be taken with the actual layout. The progressive nature of dementia means the physical space of each care facility must be sufficiently flexible to adapt to, and accommodate, the growing demand for dementia care as well as the evolving needs of individual patients.

Minimising the use of long corridors and dead-ends, for example, or developing ‘adjustable’ hospital facilities, as in Japan, where panelled partition walls can be reconfigured to suit the unique spatial requirements of individuals. This is much more cost and time-efficient way than extensive refurbishment.

Finally, once a new facility has been completed, the developer should ensure the smooth transition from empty building to operational facility, maintaining a responsibility for the functioning of the building in its first few weeks after opening.

Supporting people with dementia is one of the biggest challenges our health and social care systems will face in the years to come. Getting the physical environment right is a vital step towards improving both the life experiences and the life expectancy of those affected.